Echogram of the heart, diagnosis of the heart muscle
Jul 14, 2018
The diseases of the cardiovascular system are becoming more widespread among people of all age groups.Such a spread of cardiac pathology makes it necessary to have a simple, safe and at the same time sufficiently accurate and informative method for diagnosing such diseases.
With the massive introduction into medical practice of such a method of visualization as ultrasound, a similar diagnostic method was found.Echocardiography is a simple, affordable and safe method of research with a minimum of contraindications - ultrasound is safe even for pregnant women, and moreover, it is used as a planned method of examining the fetus.
specialists often use ultrasound diagnostic methods because of informativeness and almost immediately the results, patients as well refer to such studies because of their full painless( but with transesophageal echocardiography may be discomfort when administered sensor transthoracic same research method does not cause any inconvenienceOr painful sensations at all).
- Physical basis of the method of ultrasound diagnostics
- Features various modes of ultrasonic devices
- Indications and contraindications for echocardiography
- Transesophageal echocardiography - features of the method
- Stress echocardiography - indications for the study
- Doppler Heart Study andVessels
- Features of interpretation of ultrasound data
Ultrasound examinationdovanie - the physical basis of diagnostic method
From a physical point of view, the basis of ultrasound diagnosis - is a direct pezoelektricheskoy effect.Crystals of some chemical substances, when hit by ultrasonic waves, form electric charges on the surface, and the action of an alternating electric charge on such a crystal leads to the fact that it starts to emit ultrasonic waves.
This means that one element of the device can alternately work as a radiation generator or as a receiver of ultrasonic vibrations.
Any of the media to some extent interferes with the passage of ultrasound, but the most important changes in the waves occur when two media intersect with different acoustic impedance values.At this boundary, some of the waves are reflected back, and recorded by the sensor, and part penetrates further.
degree of reflection to the greatest extent dependent on the difference between acoustic impedances mutually bordering tissues - the greater will be the difference, the greater the proportion of ultrasonic waves will be reflected, the more intense will be the recorded signal sensor sledovavtelno image on the instrument display will lightenAnd bright.
The signals are best reflected by the boundary between tissues and air, which makes it necessary to use a special gel for diagnosis.
The operating principle of another popular method of research - Dopplerography differs somewhat.In this case, the so-called Doppler effect is applied-a change in the physical characteristics of signals reflected from moving objects.
Features of different modes of operation of ultrasonic devices
The image that is displayed on the screen of the device can vary significantly depending on the selected mode of operation of the device.
mode information is output as a one-dimensional image, one coordinate of which is characteristic of the reflected signal amplitude and the other - the distance to the boundary environments where there was a reflection of the ultrasonic wave.Based on the fact that the speed of the ultrasound passing through the body tissue is known, it is possible to determine the exact distance to the media boundary( but it should not be forgotten that the ultrasonic wave is doing its way twice - from the sensor to the media boundaries and back).
Mode In this mode of the apparatus is obtained two-dimensional tomographic images of the selected anatomic structures for diagnostic, importantly, information obtained in this study in real time.
M operating mode
The image in this mode of operation is one-dimensional, with one defined coordinate being the distance to the structure under study and the other being the time.Information in this mode is displayed in the form of different shapes of curves, reflecting the features of the movement of different structures.The method is used primarily in cardiology to assess the state of heart valves.
Most modern ultrasound devices allow you to perform research in all three modes, which allows you to gather the most complete information about the organ under investigation.
Echocardiography - indications and contraindications for performing the
study. The ultrasound examination of the heart is indicated in a number of cases:
- In the presence of complaints of discomfort, pain in the heart, feelings of disruption in his work, and other similar complaints.
- In the presence of complaints of shortness of breath - so you can more accurately determine whether the lung or heart damage causes this symptom.
- Cases of dizziness, uncaused weakness and / or loss of consciousness.
- The performance of ultrasound examination of the heart and for auscultatory detection of noises or pathological tones is shown.
- Ischemic heart disease, signs of heart failure and hypertension is also an indication for performing an echocardiographic study.
- When suspected of congenital or acquired heart and trunk vascular malformations.
There are no absolute contraindications for ultrasonography, but there are a number of cases in which it can be more or less difficult:
- Patients with significant chest deformities.
- Patients with inflammatory lesions of the skin of the thoracic mesh.
- It is also difficult to perform an ultrasound examination in the case of significant hairiness of the anterior chest wall in men, as well as in the case of large mammary glands in women.
Features of transesophageal echocardiography
Transesophageal echocardiography is also a method of visualizing the heart with ultrasound, but the main difference from the more commonly used transthoracic technique is the introduction of a sensor into the esophagus.
With this arrangement of the sensor, it is as close to the heart as possible, which means that the passage of ultrasound does not interfere with other anatomical formations, which allows to obtain a much more detailed image, including those areas of the heart, diagnosis of which is difficult in normal research.
In contrast to the more conventional transthoracic technique of the study, transesophageal water requires some preliminary preparation of the patient.First of all, the preparation consists in the advance examination of the esophagus for the presence of diseases in which such a study is contraindicated.
The patient should also refrain from eating at least six hours before the test.
However, this informative method of study has contraindications:
- Contraindicated in performing transesophageal echocardiography in malignant or benign neoplasms of the esophagus.
- With esophageal stricture, as well as bleeding from varicose veins of the esophagus.
- may also interfere with the study. Mental disorders, as well as severe gag reflex.
- Inflammation of the esophagus.
- Presence of varicose veins of the esophagus.
- A recent radiation treatment in the thoracic region.
Stress echocardiography - features of the ultrasound diagnostic method
If the usual echocardiography is performed in a relaxed state, the main difference between stress echocardiography is the study of the features of the heart with increased frequency of its contractions.An increase in the heart rate is achieved either due to exercise, or through the administration of certain medications.
Such a study can be very informative in a number of cases, for example, for diagnosis of early stages of coronary heart disease - in a calm state, obvious violations can not be fixed either during electrocardiography or in the usual ultrasound study.
But as the frequency of contractions increases, the situation changes somewhat - areas of the cardiac muscle with impaired contractility can be determined, which will speak in favor of the presence of an early stage of ischemic heart disease.
However, this study has a number of possible complications, and therefore is contraindicated when:
- Severe heart damage and heart failure.
- Various acute infectious diseases.
- Elevated blood pressure, tachycardia at rest.
- Intolerance of drugs used in the study.
- A number of diseases in the stage of subcompensation and especially decompensation.
- Mental disorders.
Dopplerographic examination of the arterial vessels and heart
Dopplerography is one of the variants of ultrasound research, the physical basis of which is the Doppler effect - the change in the parameters of the wave reflected from the moving body.In the blood vessels and chambers of the heart, the role of such bodies is performed by the uniform elements of the blood.
Assessing the peculiarities of blood flow in the heart and the main vessels can reveal congenital heart defects in children, such as, for example, an open oval window, an interventricular septal defect, an open duct between the pulmonary artery and aorta, and much more.
In adults, dopplerography is most often used to diagnose cardiac valve function disorders.Such a study may be considered safer, but at the same time a slightly less valuable alternative in the diagnostic plan for angiography.
Doppler study is non-invasive, cheaper and faster, but in a number of cases, maximum information in vascular disease can be achieved only with angiography.
Interpretation of ultrasound findings of the heart results
Evaluation of the data obtained during ultrasound examination of the heart and blood vessels should be performed exclusively by experienced specialists.
The value of almost all the parameters studied can depend on a number of factors - age, sex, body weight, lifestyle, professional occupation of a sport can lead to significant changes in a number of indicators, but not necessarily this will be a pathology.
Likewise, more attention is paid to the left ventricle, since it is the left ventricle, which receives a greater load, more often suffers from various lesions.
For ultrasound examination of the heart, attention is paid to such indices:
- The thickness of the walls of the left and right ventricles, as well as the interventricular septum.Systolic and diastolic volumes of the left ventricle.
- Emission fraction.
- Shock volume.
- Dimensions of the aorta and other major vessels.
Examples of diseases that can be diagnosed by echocardiographic signs even without using Doppler regimen can be considered:
- Valve stenosis - there will be a clear violation of the movement of valve flaps.
- Mitral valve prolapse - in the systole, the valve leaf swells into the atrium cavity by more than five millimeters.
- Neoplasms - form absent in the normal structure of high density.
- Exercise pericarditis - when ultrasound is determined by the presence of excess fluid between the pericardial sheets, the volume of space between them can also be judged on the severity of the process.
Echocardiography is an informative, safe and affordable method of examining the heart and the main vessels.
In combination with other research methods, such as, for example, electrocardiography and angiography, you can get the most complete information about the state of the circulatory system.
However, it should not be forgotten that a professional should be engaged in the evaluation of the data obtained in the study and the appointment of appropriate treatment, since not a specialist, even armed with several directories, will most likely not be able to take into account all the factors.